Programmatic Factors Affecting Infant and Child Mortality in a District of Maharashtra: Perspectives and Challenges

Abstract

Background: The decline in infant mortality rate of Maharashtra 12 points (33.3%) since 2005. As per the Sample Registration System report 2013, the neonatal mortality rate of Maharashtra was 11 points below the national level. Still about 65% of child deaths are during neonatal period and about 27% child deaths are taking place after neonatal period and before 1st year of birth. Objectives: The objective is to study innovations in reducing infant and child mortality under National Rural Health Mission in the State of Maharashtra. Materials and Methods: This study is conducted in district Pune which is one of the better performing districts in terms of child health care in Maharashtra to see programmatic factors affecting infant and child mortality in the district. Results: It is found that district Pune has required health facilities at different levels as per GOI norms but lacks specialists. A large proportion of women still access government facilities for pregnancy - and childbirth-related services. High anemia among women and low birth weight (LBW) are important factors affecting infant and child mortality. Conclusion: It is concluded that there are a few shortfalls in achievements that get accentuated when disaggregated by gender, rural–urban sectors and social groups at the grass root level. There is need to further strengthen Special Newborn Care Units at continuous home care level to address causes of deaths like LBW, asphyxia, congenital abnormalities, etc.